Abstract
Background
To compare the efficacy of Adalimumab (ADA) in noninfectious anterior uveitis (AU) and posterior segment (PS) involvement, associated with different conditions, with a focus on Behçet’s syndrome (BS).
Methods
In this retrospective, multicenter post-hoc study, we evaluated the efficacy of ADA in terms of ocular control and relapses in 96 patients with AU and PS uveitis, either idiopathic (IU) or associated with BS or with other systemic disorders (OSD) (Juvenile Idiopathic Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, Vogt-Koyanagi-Harada, Inflammatory Bowel Disease), followed in three tertiary referral centers.
Results
Ninety-six patients (45 AU; 51 PS uveitis) were included. Eleven had IU, 58 BS, and 27 OSD. All patients with AU achieved complete long-term ocular control. In PS uveitis, 89%, 67% and 100% of patients with BS, IU and OSD achieved ocular control at the last follow-up (> 12 months), respectively. The lowest ocular relapse rate occurred in patients with AU with BS (1/13) or IU (0/2). ADA accounted for long-term disease control, and no predictors of ocular control and relapse were identified; particularly, ocular relapses seemed not related to systemic ones. Macular edema resolved in 75% and 67% of PS uveitis with BS and IU, respectively.
Conclusions
ADA controls both anterior and posterior uveitis, with an efficacy similar in IU, BS and OSD patients. In BS, the efficacy of ADA seems to be independent of demographic and clinical characteristics, and ocular relapses mostly occurred independently from systemic ones. Based on our results, ADA may represent a valid alternative in anterior refractory uveitis.
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Data availability
The data used to support the findings of this study are available from the corresponding author upon request.
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Ethical approval was waived by the ethics committee of Careggi University Hospital (CEAVC Reference number: 13366). The procedures used in this study adhere to the tenets of the Declaration of Helsinki. In view of the retrospective nature of the study and all the procedures being performed were part of the routine care.
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Lorenzo Vannozzi and Domenico Prisco share senior authorship.
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Silvestri, E., Bitossi, A., Bettiol, A. et al. Adalimumab effectively controls both anterior and posterior noninfectious uveitis associated with systemic inflammatory diseases: focus on Behçet’s syndrome. Inflammopharmacol 28, 711–718 (2020). https://doi.org/10.1007/s10787-020-00697-4
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DOI: https://doi.org/10.1007/s10787-020-00697-4